| NPI | 1376696096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FABIOLA GONZALEZ CEO 360-266-5585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2022-07-12 |